According to the 2000 census, there are approximately 93,000 American Indian/Alaska Native (AIAN) people in the state of Washington (1.6% of the total population). AIAN individuals and communities are distributed across the state with communities ranging from small, rural groups to urban, inter-Tribal ones. Due to complex relationships between Tribes and local, state, and federal agencies, healthcare may be provided either by the Tribe, local service providers, the state, an Indian Health Service facility, a regional Native Health Board, or by some combination of the above. Because of this, there is very little empirical data about health disparities as they are experienced by AIAN communities, especially in regards to mental health and substance abuse services. Little is also known about the many community-developed programs that often incorporate Tribal values, practices, and beliefs, and have anecdotal evidence of effectiveness. Finally, a lack of funding and overburdened resources result in decreased access to appropriate training for many mental health and substance abuse service providers working with Tribal communities. Because of this, we are proposing to hold a 1 1/2 day long Washington State Tribal Healing and Wellness Conference in March 2007 that would bring together representatives from the 29 federally recognized Tribes, other AIAN agencies, and urban AIAN communities. The conference will include 2 panels with expertise in the areas of health disparities, substance abuse, and mental health issues among AIAN populations. Additionally, breakout sessions will be facilitated by panel members and address the five objectives listed below. The primary objectives of the conference, which will be held on the Port Madison Reservation located across Elliot Bay from Seattle, will be to: 1) identify substance abuse and mental health disparity issues of greatest concern to urban, rural, and reservation Tribal communities; 2) identify best practices that have been developed in Tribal communities to address such issues but that may be lacking strong empirical evidence; 3) educate Tribal communities and researchers by providing expert speakers who can address health issues of concern to Tribal communities; 4) provide specific clinical skills for working with AIAN communities regarding mental health and substance abuse; and 5) provide an opportunity for Tribal organizations to connect and collaborate with researchers and research institutions, and to network with other Tribal communities. A conference report will document identified health issues of concern to Tribal communities, evidence-based approaches currently used to address these needs, and other community-based interventions that appear promising but are in need of evaluation. This report will set the agenda for future conferences, and will help develop a research agenda for collaborative, community-based research addressing identified areas of health disparity. [unreadable] [unreadable] [unreadable]